The Efficacy Observation Of Furazolidone-based Quadruple Therapy As First-line Treatment For Helicobacter Pylori Infection

Objectives1.To view and compare the rate of symptom remission and adverse reactions of furazolidone-based quadruple therapy as first-line treatment for patients with H.pylori,2. To view and compare the H.pylori eradication rate of furazolidone-based quadruple therapy as first-line treatment for patients with H.pylori with clarithromycin quadruple therapy.Subjects and methodsSubjects:152patients with upper gastrointestinal symptoms underwent electronic gastroscope and H.pylori tests(RUT,Histopathology,UBT) and were diagnosed as Hp-positive chronic gastritis or duodenal ulcer.Methods:152patients were randomly divided into three groups:the control group received esomeprazole20mg,bismuth potassium critrate220mg,amoxicillin1000mg and clarithromycin500mg,twice a day for7days;furazolidone-based quadruple7days group received esomeprazole20mg,bismuth potassium critrate220mg,amoxicillin1000mg and furazolidone100mg,twice a day for7days; furazolidone-based quadruple10days group received esomeprazole20mg,bismuth potassium critrate220mg,amoxicillin1000mg and furazolidone100mg,twice a day for10days.Followed up and record the symptom remission and adverse reactions,observed their compliance and tolerance.After at least4weeks of the treatment and2weeks of nonuse of PPI, H.pylori eradication was checked by UBT. H.pylori eradication rate was analyzed by PP and ITT analysis.Used two index of cost-effectiveness analysis(cost-effectiveness ratio and incremental cost-effectiveness ratio) to evaluate the three treatment.Use SPSS17.0 statistical analysis software to analysis.Qualitative data,which was exptessed by percentage, was compared with Chi-square test or Fisher’s exact test.Quantitative date were compared with multiple sample ANOVA test. When P<0.05,it considered statistically significant.Results1.Totally,140cases completed the study,the total efficiency is77.86%.The rates of symptom remission in the three groups were75%,77.78%and80.85%.There was no significant difference(P>0.05).2. The rates of adverse reactions in the three groups were10.42%,13.33%and6.38%.There was no significant difference(P>0.05).3.On PP analysis,the H.pylori eradication rate of the three groups were87.50%,88.89%and93.62%.On ITT analysis, the H.pylori eradication rate of the three groups were79.25%,83.33%and86.27%. There was no significant difference either on PP analysis or on ITT analysis.4. Among the three groups of patients with duodenal ulcer, The H.pylori eradication rate was no significant difference. Among the three groups of patients with chronic gastritis, the H.pylori eradication rate was no significant difference.The H.pylori eradication rate of patients with duodenal ulcer was higher than that of patients with chronic gastritis in the three groups, The eradication rate of patients with duodenal ulcer or chronic gastritis was similar in the three groups.5.The cost-effectiveness ratio of the three groups were3.69,2.48and3.37.the incremental cost-effectiveness ratio of furazolidone-based quadruple7days group was-73.22as against control group; the incremental cost-effectiveness ratio of furazolidone-based quadruple10days group was-1.17as against control group.Conclusions1.0There was no significant difference in the rate of symptom remission and adverse reactions among the three groups. 2.Among the three groups,the eradications rate of patients with duodenal ulcer or chronic gastritis were similar.3.In the three groups,the eradication of patients with duodenal ulcer was higher than that of patients with chronic gastritis,but there was no significant difference between them.4.Both H.pylori eradication rates of furazolidone-based quadruple7days and10days group are higher than that of control group,both of them have high eradication rates,and there is few slightly side effects,whatmore,they can reduce the cost of quadruple treatment,both of the two treatments,which are safe,effective and economical first-line treatment and accord with the situations of our country,can be recommended for clinical practice.